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Navy & Marine Corps Medical News
June 30, 2000
This message has been coordinated with the commandant of
the Marine Corps (CMC) . The commandant has authorized
transmission to Marine Corps activities.
Navy and Marine Corps Medical News (MEDNEWS) is a weekly
compendium of news and information contributed by commands
throughout the Navy Medical department . Information contained
in MEDNEWS stories is not necessarily endorsed by BUMED,
nor should it be considered official Navy policy.
The Navy Bureau of Medicine and Surgery distributes MEDNEWS
to Sailors and Marines, their families, civilian employees and
retired Navy and Marine Corps families . Further distribution
is highly encouraged.
Stories in MEDNEWS use these abbreviations after a Navy
medical professional ' s name to show affiliation: MC —
Medical Corps (physician) ; DC - Dental Corps; NC - Nurse
Corps; MSC - Medical Service Corps (clinicians, researchers
and administrative managers) . Hospital Corpsmen (HM) and
Dental Technician (DT) designators are placed in front of
Contents for this week's MEDNEWS:
— Experimental medical information systems tested during RIMPAC 2000
— Pacific military treatment facilities now under one survey
— Addiction treatment facility opening its door to entire defense family
— Foreign nurses oriented in Orient
— Great Lakes corpsmen lend support to recruiting efforts
— Two new sites expand FEHBP military retiree demo
— 2000 edition of U.S. Navy shipboard pest control manual is available
— TRICARE question and answer
— Anthrax question and answer
— Healthwatch: Some known and little known facts about calcium
Experimental medical information systems tested during RIMPAC
By J02 (SS) Dave Kaylor, RIMPAC 2000 Combined Information
The international maritime exercise Rim of the Pacific
(RIMPAC) 2000 served as the testing ground for hi-tech
medical experiments funded by the Defense Advanced Research
Projects Agency (DARPA) .
The experiments are in various stages of development,
according to 3rd Fleet Surgeon, Lt.Cmdr. Eric Rasmussen.
They exhibited varying degrees of success, but all performed
better then expected.
The staging ground for these experiments was "Strong
Angel, " a humanitarian refugee assistance exercise conducted
in a barren region on the big island of Hawaii . The
interagency exercise included a number of United Nations and
non— governmental organizations. "Strong Angel" marked the
first time a humanitarian exercise was an integral part of
"We were able to build a large scale exercise, " said
Rasmussen, "because we had experimentation funding. "
Three of the experiments in particular were highlights
during the humanitarian exercise. The first was a simple
phrase-based translation system. In a refugee situation like
the one simulated in "Strong Angel, " a care provider can
communicate with non— English speaking refugees.
A corpsman speaks a particular phrase into the built— in
microphone on a Fujitsu 2300 tablet. The phrase is then
translated and played back in the selected language. For
example, the corpsman might say in English to a Swahili
speaking refugee, "I am a member of the North Atlantic
Treaty Organization peace keeping forces. " The refugee would
then hear that phrase translated into Swahili .
It is designed to be a screening system allowing a care
provider to quickly extract simple registration information
from refugees. It communicates in either short statements or
solicits simple answers to general questions. If it is
determined that more information from a particular
individual is needed, that person would then be sent to a
table set up with the two— way translation system.
"It's a simple way to do 20 questions, " said Rasmussen.
"The result has been a fairly robust 20 question system
where you and I can be mute, not have one word in common,
but still communicate with each other. It worked
beautifully . We will be pushing it forward, probably into
central Africa in November . "
Also performing well during the exercise was the two-
way translation system. Much more complicated, it consists
of two side-by-side laptops. English is spoken into a
headset attached to the first laptop. After recording the
information utilizing voice recognition software, the
con^uter then translates it into the selected language and
plays it back through the speaker of the second laptop,
enabling a two-way conversation between individuals speaking
different languages . At this early stage, Korean is the only
language to be translated in the new system.
"That 's because we needed a huge body of parallel
information, " said Rasmussen. "It turns out that the best
examples were the twice daily battle briefings given in
South Korea. U.S. Forces and Republic of Korea Forces are
given those briefings simultaneously in English and Korean.
Those were absolutely perfect translations with a body of
translators standing by to assist. "
After feeding the simultaneous information into the
computers, the next step was to build statistical
translation models. Many of the Korean officers used to
evaluate the new system during its development are now
participants in RIMPAC 2000.
Interactive Drama, named after the Maryland company
responsible for its development, is another experiment
consisting of pre— recorded information on a topic stored on
a digital video disc (DVD) . One of its first applications
would be to evaluate chemical weapon exposures far forward.
A subject-matter expert records the audio-visual
information. When the information is needed, a battlefield
medic asks questions into a microphone attached to the
laptop. Voice recognition techniques allow the system to
retrieve the appropriate information from the DVD. The
information is then played back showing the expert answering
"Its just as if there is a two-way conversation between
the subject matter expert and the person asking the
question, " said Rasmussen. "It looks like an interactive
television show, driven by voice. It's in the early stages
of development, so we didn't expect much, but it did fine."
One important aspect of these three systems is that
they all use standard off-the-shelf hardware. Other than the
specific software, all the equipment is non-proprietary,
making the systems easier to operate and maintain.
"We had an extremely successful set of experiments
because we scoped it carefully and we knew what we were
trying to achieve, " said Rasmussen. "We even survived the
dust . "
Pacific military treatment facilities now under one survey
By Bill Doughty, U. S. Naval Hospital Yokosuka, Japan
YOKOSUKA, Japan - A small percentage of patients
throughout mainland Japan are being randomly selected and
mailed an individualized, customized survey to help assess
the quality of care and provide feedback to hospital
The 17 multiple-choice questions survey replaces the
small, local surveys done by each command or clinic in the
"It's important that you fill it out. It helps us know
what the quality of care we're providing and whether or not
we're providing good access to care," said Lt. Paul Toland,
Head of Managed Care.
"Although information is collected independently, USNH
Yokosuka will get a report and an overall score that will
benchmark them against other facilities throughout the
Military Health System, " said LT Toland. The survey will
also help the hospital measure TRICARE Prime access goals
and patients ' overall satisfaction with customer service.
"When we get the information we're going to look at the
areas that are identified as trouble areas where we're not
meeting the goals of the Military Health System. And in
those areas we 're going to target for performance
improvement, " said LT Toland. "But, it ' s also important for
us to know the areas that where are excelling in so we can
continue to excel in those areas and share them with
For more information on the outpatient satisfaction
surveys, contact your TRICARE Service Center or visit the
TRICARE web page at www. tricare . osd.mil/tricaresurveys .
Addiction treatment facility opening its door to all
By Rod Duren, Naval Hospital Pensacola
PENSACOLA, Fla. — Naval Hospital Pensacola 's Addiction
Treatment Facility (ATF) has extended its substance
treatment programs to all military members, retirees and
their family members over age 18.
"As a part the naval hospital 's continuing efforts to
meet the needs of the entire Navy community, we are very
pleased to extend what is usually an 'active-duty only'
medical service," said Commanding Officer Capt. Robert D.
The Addiction Treatment Facility is a mid-sized Navy
unit with 13 counselors and 22 overall staff. But it is
among the "very few who are providing services for non-
active duty people, " said Cmdr. H. Wakeman Smoot,
psychiatrist and the ATF's Department Head.
"Although we are obviously excited to see this
department grow and take on the new challenges, " the
decision to extend the services is "clearly being done to
benefit the community, " said Smoot .
The ATF provides intensive counseling and intervention
on an outpatient basis for persons addicted to or abusive of
(primarily) alcohol. Although not currently offering in-
patient or residential care locally, the ATF can serve as a
liaison to other facilities, both military and civilian,
that offer that level of care.
"The Navy's drug and alcohol treatment programs are
among the best in the country. In fact. Navy alcohol
treatment programs were the prototype for most of the
country's successful treatment approaches, " said Hufstader.
"I'm pleased that we're able to open this excellent service
to even more of our people. "
Opening the ATF to the Navy Pensacola community, the
Naval Hospital is hoping to raise the awareness level and
scope of treatment to the next plane in order to assist
others in their fight against these addictions.
Foreign nurses oriented in Orient
By Cmdr. Angela Alsberry, NC, Branch Medical Clinic Atsugi
ATSUGI, Japan — Seven nurses of the Foreign Nurses
Association of Japan (FNAJ) attended a special Red Cross
orientation program June 13 at Branch Medical Clinic Atsugi,
to become certified volunteers.
According to Commanding Officer Captain Hank M.
Chinnery , this union of the BMC Atsugi and the FNAJ is a
wonderful opportunity to learn of nursing both in the
Military Healthcare setting and also the way of nursing in
other countries of the world. Having the nurses come to us
broadens our outreach to those professionals who seek to
remain active in giving patient care.
The FNAJ is composed of about 40 registered nurses from
around the world who are in Japan for unique reasons. Those
participating in March and last week were from the U.K., the
Philippines, Australia, U.S., Korea and Japan. Some of these
nurses have lived and worked in countries such as Saudia
Arabia, Malaysia and Central America.
At the conclusion of the day, all received
certification as BMC Atsugi Red Cross Volunteers.
Great Lakes corpsmen lend support to recruiting efforts
By Lt . Youssef H. Aboul-Enein, MSC, Naval Hospital PAO
GREAT LAKES, 111 . — The Great Lakes Summer Cruise 2000
hosted the USS DEFENDER (MCM-2) and USS KINGFISHER (MHC-56)
as part of its annual high school recruiting campaign the
first week of June at Chicago's Navy Pier.
Over 250, 000 attended the week— long event . Young men
and women talked with the Great Lakes Corpsmen about the
many specialties within the rating such as operating room
technician, respiratory technician and optometry technician.
"Navy Medicine is one of the many ways to realize your
dreams of becoming a physician, nurse or one of the many
allied health specialties, " said HMl Jacque Dubose to a
group of high school students.
The students toured the ships and a nearby tent manned
by over 20 Navy corpsmen and dental technician from Naval
Hospital Great Lakes, Naval Hospital Corps School and Naval
Dental Center Great Lakes displaying career and education
"The medical tent was very popular because they have
displays and hand-outs that interest young men and women who
can identify a career and skills that can be used in the
civilian world, " said DTI Cheryl Castillo. "Many of the
high school kids and their parents do not realize there is a
dental rating in the Navy and the career opportunities it
provides such as a two— year program which offers a diploma
as a dental hygienist, " said Castillo .
Naval Hospital Great Lakes medical and dental commands,
where healthcare begins for over 53, 000 recruits a year, are
inextricably linked to the recruiting efforts such as the
Great Lakes Summer Cruise 2000.
Two new sites expand FEHBP military retiree demo
From Office of the Assistant Secretary of Defense
WASHINGTON - In a move to expand alternative health
care options to military retirees over 65, the Department of
Defense announced that it recently expanded the Federal
Employee Health Benefit Program (FEHBP) demonstration
project to include two new over— 65 military retiree
These additional sites are in the surrounding ZIP code
areas of Coffee County, Ga., and Adair County, Iowa. They
expand one of the department ' s projects to determine the
most feasible way to provide health care for uniformed
services Medicare-eligible beneficiaries and certain others.
Members of the Military Coalition and the National
Military/Veterans Alliance, two consortiums of organizations
representing TRICARE beneficiaries, randomly selected "seed"
areas for the additional program sites in early April.
This congressionally mandated demonstration project
allows certain eligible uniformed services beneficiaries to
enroll in, and receive their health care through, a health
plan in the FEHBP, the same program used by civilian federal
employees and retirees . DoD will contribute the standard
government amount, which is almost three— quarters of the
pi an ' s premi um .
The expanded demonstration will target e±>out 25, 000
eligible beneficiaries in each location, increasing to
120, 000 the number of beneficiaries eligible for the FEHBP
demonstration. The Iowa site encompasses the entire state
(except ZIP code areas in the Offutt Air Force Base's
catchment area) , parts of Minnesota, South Dakota, Nebraska,
Kansas and Missouri.
The second site includes parts of Georgia, Florida and
The next enrollment opportunity at all demonstration
sites, including the two new ones, will begin in November
2000 during the FEHBP 's annual enrollment open season.
Coverage for new participants will begin Jan. 1, 2001, and
will run through Dec. 31, 2002. The U.S. Office of Personnel
Management (OPM) administers the FEHBP. OPM and DoD jointly
administer the DoD/FEHBP demonstration project .
This fall, DoD will mail "The 2001 Guide to Federal
Employees Health Benefits Plans participating in the
DoD/FEHBP Demonstration Project " to all eligible persons
within the designated ZIP code areas. The guide contains a
list of participating health plans, benefits, premiums and
Information will be available in late summer on a
series of meetings about the project that will be held in
the areas of the new demonstration sites. Beneficiaries who
meet eligibility criteria will receive notification by mail .
others may call the DoD/FEHBP Project Call Center toll-free,
1 (877) 363-3342, for further information.
For a complete list of ZIP code areas to be served by
the new demonstration sites, and other information about the
FEHBP demonstrations, visit the Military Health System
website : www. tricare . osd.mil/fehbp/
2000 edition of U.S. Navy Shipboard Pest Control Manual
The Navy Disease Vector Ecology and Control Center
Bangor has released the 2000 edition of the U.S. Navy
Shipboard Pest Control Manual .
This is the first new edition since 1984. The Shipboard
Pest Control Manual is a comprehensive reference that covers
all aspects of pest control for U.S. Navy Ships. The manual
is a companion to the Shipboard Pest Management Course (CIN
B— 322-2075) . Numerous color photos of pests and pest control
subjects have been added. The biology of the major
shipboard pests, such as cockroaches, rats and stored
product pests are covered.
All of the chapters have been updated with new and
improved pest meLnagement techniques merged with the bedrock
principles of pest management . A new chapter on quarantine
issues has been added that covers background information on
quarantine responsibilities of the Navy.
The manual also includes the Navy Environmental Health
Center approved Authorized Shipboard Pesticide list . Copies
of the manual will be made available at Shipboard Pest
Management classes. To register for a Shipboard Pest
Management class contact your local medical entomologist at
a Navy Disease Vector Ecology and Control Center or Navy
Environmental and Preventive Medicine Unit . The manual is
also available for download at the NDVECC Bangor website,
www. ndvecc . navy.mil .
TRICARE question and answer
Question: Is preventive care covered under Standard or
Answer: Preventive care is an added benefit under Prime. If
the particular preventive service is a benefit included
under the TRICARE Standard (CHAMPUS) benefits, you will be
responsible for the deductible and co-payment under Extra
and Standard. See your Health Benefits Representative about
specific preventive care under TRICARE Standard.
Anthrax question and answer
Question: Why do we think the anthrax vaccine will protect
people if anthrax inhalation occurs? What scientific
evidence do we have?
Answer: The original Brachman and CDC studies of anthrax
vaccine in textile workers proved that the vaccine protected
against anthrax. The calculations performed in that study
combined the cutaneous (skin) and inhalation forms of
anthrax infection that occurred. No inhalation anthrax
occurred among the vaccinated workers, while five cases of
inhalation anthrax occurred among workers who had not been
vaccinated. The total number of cases was judged too few to
show statistically conclusive proof of protection.
However, results from several animal studies provide
additional evidence that the vaccine protects against
anthrax challenge with more than 500 times the lethal dose
of anthrax by inhalation. This information coupled with the
encouraging results of the effectiveness and immune response
in humans assures us that the vaccine will greatly increase
the chances of servicemembers surviving exposure to
inhalation anthrax. When full immunization is combined with
proper use of protective masks, detection devices,
surveillance and post-exposure treatment with antibiotics,
the threat is even further reduced.
Healthwatch: Some known and little known facts about calcium
Calcium is the most abundant mineral in the human body.
About 99 percent of the body's calcium is in the bones and
the rest is in the soft tissues. Most people know that
calcium is needed for building and maintaining bones and
teeth. But did you know that calcium also:
— Helps regulate the heartbeat (along with magnesium)
— Helps the blood clot and maintain a balance of acid
— Helps muscles grow and contract
— Helps nerves transmit
— Helps the body use iron
— Helps activate several enzymes (so other nutrients
— Helps regulate the passage of nutrients in and out of
the cell walls ?
The calcium that does all this work circulates in the
blood, and the body regulates the level of blood calcium
very carefully. Extra calcium is stored in the bones, where
it can be released quickly if the level of calcium in the
blood drops too low.
Despite its importance to the human body, calcium is
available in significant amounts from very few foods. Most
people think of dairy products as sources of calcium, and
milk, yogurt, hard cheeses, and cottage cheese are excellent
sources. However, not all dairy products are good sources of
calcium. For example, butter, sour cream and cream cheese
contain minimal amounts of the minerals. Nondairy sources of
calcium include broccoli, dark green leafy vegetables, tofu,
beans, peas, lentils and canned fish with soft edible bones.
As you get older, your body's ability to absorb
nutrients declines, so you need to take more calcium.
Adequate calcium helps prevent osteoporosis, a disease that
causes the bones to become porous and fragile because
calcium is withdrawn faster than it is deposited.
On the other had, too much calcium in your diet can
result in hypercalcemia, an excessive buildup of calcium in
the bones and some tissues, such as the kidneys. People who
rely on tablets or other supplements to supply calcium,
instead of relying on dietary sources, may be more prone to
When it comes to calcium, as well as other important
nutrients, the best advice is to eat a varied but balanced
diet that 's rich in complex carbohydrates, low in fat, and
includes moderate amounts of protein.
Comments about and ideas for MEDNEWS are welcome . Story
submissions are encouraged. Contact MEDNEWS editor, at
email: email@example.com; Telephone 202/762—3218,
(DSN) 762, or fax 202/762-3224.